Dr. Rob and the Bureaucracy

One of the myths of being self-employed in the mental health field is that you are free from bureaucracy and Corporate America. Many people assume that working in psychology allows complete freedom in the workplace. Little could be further from the truth. Whether it’s dealing with insurance panels, submitting personal injury statements to lawyers or writing doctor’s notes for clients I too deal with red tape and paperwork like it’s going out of style. Even as a simple consultant at a local hospital I am not free from the stranglehold that is “The Man.”

A few months ago a call came in from Joan, the Surgical Coordinator at _______ Hospital.
“Rob, you can’t come back to work.”

“Why? Am I fired?”

“No the state is requiring all of our treatment providers to be credentialed before working here. You literally can’t step foot in the building until you’ve applied to work here.”

“But I’m not a treatment provider. I just do the weight loss evaluations.”

“This applies to all providers, regardless of role.”

“I’ve worked there for five years, can’t they make an exception in my case?”

“Sorry Rob it’s not in my hands.”

“So who is going to do the psychological evaluations while I’m not there?”

“They are being temporarily outsourced to a local practitioner.”

“You’re giving my work to a competitor? Judas!”

“Your application is already in the mail. Please complete it right away and we can have you back within the month.”

I got the packet two weeks later, immediately putting me behind schedule. I filled out the application which consisted of mostly questions related to academic background and sent it off. I got a call two weeks later from a woman in the Credentialing Office.

“Dr. Dobrenski, we need some ancillary materials from you.”

“Ancillary?”

“Most of what we need can be photocopied and faxed: license to practice, malpractice insurance form, graduate transcripts and your diploma.”

“They have all of those things in the Department of Surgery.”

“Well,” she said, “it would better if you sent them yourself.”

“Better for whom?”

“Me.”

“But my diploma has been framed and matted.”

“I suppose you could try to put the entire frame under the copy machine” she said.

“You said most things can be faxed. What cannot be faxed?”

“This may sound a bit silly…”

“This all sounds silly.”

“But I need you to come out here with your driver’s license to prove that you are, in fact, you.”

If you are unfamiliar with New York City note that it can easily take over an hour to drive 10 miles. This is particularly annoying when I clearly know that I am me.

“There are plenty of people at the hospital who can verify who I am.”

“Sorry it’s per regulation.”

“If I can’t get the giant diploma under the copy machine can I at least bring it out to you so that I don’t have to de-mat it?”

“No.”

I think I hate you. “Fine, when can I come out and prove my existence?”

“I see applicants on Monday from 4:15 to 5 and Friday 4:30 to 5:30.”

Perfectly timed for rush hour, you nefarious shrew.

I copied one-half of my diploma (the other half couldn’t fit under the machine cover), thus having one line as “Rober” and the next line as “Psycho.” I mailed in all of the required materials and went out to the hospital. The woman at the Credentialing Office eyed the driver’s license.

“This doesn’t look like you.”

“It’s a few years old.”

“You don’t have a more recent one?”

“I don’t carry more than one driver’s license at a time, but I can assure you it’s me.”

“Hmmm…okay. Have you taken your online Infectious Disease course yet?”

“I don’t deal with any infectious diseases.”

“Oh but you must take the course. Regulations. Register and take the course as soon as possible. You can do it all on the hospital’s website. And it isn’t very expensive either.”

“The hospital is not going to pay for it I take?”

“It is the applicant’s responsibility. When you’ve passed that class then we will set up your interview.”

“My interview?”

“Yes, everyone must meet with the head of neurology.”

“I’m not a neurologist. I’m a psychologist and I work in surgery.”

At this point she was probably wondering how someone so contrary and cranky could possibly help people for a living. “It doesn’t matter what you are, you still need to meet with him. Go and get your course done.”

I took the online course that night. Only true experts in infectious disease control could possibly thrive on an exam with such difficult questions as:

– Where should one dispose of a used syringe?

a) In a wastepaper basket
b) In a clearly designated receptacle that contains a boldly displayed warning sign that says “Place Used Syringes Here!”
c) In a desk drawer

– Who is most responsible for infectious disease control?

a) the janitors
b) the terminally ill patients
c) no one
d) you and your colleagues at your highly competent treatment facility

I actually got one wrong for failing to read the question correctly (I missed the word ‘not’ in the sentence “true or false: you should not transmit diseases”). That being said my 96% was well above the 80% required to pass the course. How someone could get 80% and be allowed to handle syringes that might be contaminated with HIV is strange to me.

Because the head of Neurology was booked for the next four weeks I had to wait for my interview and have it at 6 PM on a Friday. Given my long-standing relationship with the hospital I assumed this interview was perfunctory. I make a lot of assumptions that don’t seem to pan out.

“You aren’t wearing a suit” was the first thing that Dr. Jones said, a sign above his desk that read “Neurologists do it with a lot of nerve.”

“I’m…not. Right.”

“Why?”

“I didn’t know that I was supposed to.”

“This is a job interview.”

“I didn’t realize this was a formal interview. And I don’t actually own a suit.”

“You don’t own a suit? What do you do when you apply for jobs?”

“I haven’t applied for a job in five years. I wore a suit to that one but I imagine it’s out of style now.”

“What if you are invited to be in a wedding party?”

“I suppose I would rent a tuxedo then.”

“I see,” he said and started scribbling something on a legal pad. “Tell me about your previous job history.”

“Here.”

“I’m sorry?”

“I’ve worked here for the past five years,” I said.

“You’ve been employed here for five years and you’re just getting credentialed now? That’s highly irresponsible.”

“I suppose it is.”

“You don’t seem to have much compunction for this.”

“You think I’m responsible for this? I simply applied for the job years ago, got the job and have since been doing my job until I was told that the hospital had a new policy in place.”

“No no, this policy has always been in place and we thought you were a new applicant.”

He paused, erroneously realizing that I had consciously and maliciously been working for five years without being credentialed. “I guess you’re quite the rebellious one then, young fellow. Ha!”

“Yes I suppose I am.”

“Let me get some coffee, I’ll get more of your work history at this hospital and then we’ll begin the fun part of the interview.”

Fun part?

“We’re going to do a lightning round of what I call “What Should Dr. Dobrenski Do During a Crisis at _______ Hospital. Won’t that be terrific!?”

If I stabbed this man in the chest right now and ran, maybe no one would find out.

This entry was posted on Thursday, March 20th, 2008 at 12:14 am and is filed under Blog. You can follow any responses to this entry through the RSS 2.0 feed.
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17 Responses to “Dr. Rob and the Bureaucracy”

There are times when I love working in IT and living in the middle of skills shortage.
“The hospital is not going to pay for it I take?”
“It is the applicant’s responsibility.”
“Tell my replacement I said best of luck”

Wow, that’s just, wow. I can’t wait to see what happened, seeing as if there really was a crisis, I don’t think you could do much besides give mental consultation…What would happen if someone had a heart attack in such a situation? Yup…

Bahaha, I can’t wait to see what happened after that, and the explanation to see how you were working there for five years without being credentialed.
(“The hospital is not going to pay for it I take?” -Add a comma after it.)

That was great, I’m looking forward to the end of this.
I’m very accustom to those stupid online courses from working in banking. Many of them simply ask if you read and understood everything, click yes and you pass.

Oi. You’re far more patient than I. I would have walked when the woman said she needed you to bring your license to the hospital to verify that you were you. That’s just ignorance.
PS: I was having withdrawals and you just made my day!

God I hate taking my diploma down to Office Max and shoving it on the copier. That reminds me of when I applied to accept a new insurance. I had to write a emergency policy for the office that covered everything from robbery to terrorist attack. It’s a 3 room office and I’m the only employee. Oh what fun.

My god, I can’t believe that you are able to handle this. These situations… When dealing with bureaucracy, you just want to bash your head in.
Taiwanese bureaucracy is the worst I’ve seen, though I have only lived in a few countries, the Chinese have a special way of making you go bonkers.
Looking forward to the next part.

Holy crap man. I’m wondering if I have things like this happen in my life. I think that I suppress them after I’ve dealt with them in some efficient manner at the moment of the occurrence. Seriously, this is insane, and I thank you.